Cytotoxic chemotherapy in the contemporary management of metastatic castration‐resistant prostate cancer (mCRPC)

Abstract

. contributed equally.For several years, docetaxel was the only treatment shown to improve survival of patients with metastatic castrationresistant prostate cancer (mCRPC). There are now several novel agents available, although chemotherapy with docetaxel and cabazitaxel continues to play an important role. However, the increasing number of available agents will inevitably affect the timing of chemotherapy and therefore it may be important to offer this approach before declining performance status renders patients ineligible for chemotherapy. Patient selection is also important to optimise treatment benefit. The role of predictive biomarkers has assumed greater importance due to the development of multiple agents and resistance to available agents. In addition, the optimal sequence of treatments remains undefined and requires further study in order to maximize long-term outcomes. We provide an overview of the clinical data supporting the role of chemotherapy in the treatment of mCRPC and the emerging role in metastatic castration-sensitive prostate cancer. We review the key issues in the management of patients including selection of patients for chemotherapy, when to start chemotherapy, and how best to sequence treatments to maximise outcomes. In addition, we briefly summarise the promising new chemotherapeutic agents in development in the context of emerging therapies.

Consequences of an Early PSA Response to Enzalutamide Treatment for Japanese Patients with Metastatic Castration-resistant Prostate Cancer

“…Chi et al (19) proposed that 12 months was the key time at which to evaluate responses to AR-targeting agents and recommended that patients showing shorter times to CRPC should be considered for upfront use of docetaxel. Sonpavde et al (20) proposed that a time of 16 months to CRPC should trigger upfront use of chemotherapy (20). In our present study, a time of 16 months to mCRPC significantly predicted a 50% PSA response.…”

Chemotherapy induces ovarian cancer cell repopulation through the caspase 3-mediated arachidonic acid metabolic pathway

“… 22 Cytotoxin chemotherapy is a common type of chemotherapy and is widely used in systemic therapy for cancer treatment. 23 Previous studies have reported that radiotherapy or chemotherapy can lead to the measurable regrowth of tumor cells. 7 , 8 In addition, PGE 2 promotes the proliferation of cancer cells and stem cells in different types of cancer.…”

Therapy decisions for the symptomatic patient with metastatic castration-resistant prostate cancer

“…There is retrospective evidence to suggest that cabazitaxel before abiraterone acetate may be the preferred order after progression on docetaxel, but a prospective study would be necessary to clarify. 15 In addition, the increasing use of abiraterone acetate in prechemotherapy patients and recent approval of enzalutamide in this setting will likely narrow down the list of potential treatments after docetaxel. Molecular targeted therapies, next-generation antiandrogens, and immunotherapies are currently in the research pipeline and may further expand the list of treatment options both in the chemotherapy-naïve patient and postdocetaxel.…”